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General NPI Number Information
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NPI Number | 1265834816
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Entity Type | Organization
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Legal Business Name | NATURES GRACE ACUPUNCTURE CENTER, INC.
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 25470 MEDICAL CENTER DR #104
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City | MURRIETA
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State | CA
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Zip | 92562-4900
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Country | US
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Telephone | 951-296-1688
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Fax | 951-696-3588
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Provider Business Mailing Address
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Address Line | 25470 MEDICAL CENTER DR #104
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City | MURRIETA
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State | CA
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Zip | 92562-4900
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Country | US
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Telephone | 951-296-1688
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Fax | 951-696-3588
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Authorized Official
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Title or Position | CEO/PRESIDENT/OWNER
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Name | DR. QIANG YANG
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Credential | L. AC.
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Telephone | 951-296-1688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 5922
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License Number State | CA
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